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Qi is insufficient; if the climate arrives before the solar term, it indicates an excess of the incoming qi. The Yellow Emperor asked: What happens when the solar term arrives but the climate does not, or when the climate arrives before the solar term? Qibo replied: When it corresponds, it is smooth (shun); when it does not correspond, it is contrary (ni). Contrariety generates changes, and changes generate diseases. The Yellow Emperor said: Good. Please explain what "correspondence" means. Qibo said: The growth of all things corresponds to the climate; the pulse corresponds to the six qi. (From *Suwen: Liuhui Zhi Dalun*)

This chapter discusses the yin and yang of Heaven, and the normal course of the Heavenly Dao rotating to the right. By "upper," it refers to the rightward movement. The waxing and waning of the Heavenly Dao in cycles of six-six years occurs as the Three Yin and Three Yang of Heaven rotate to the right outside the celestial sphere, taking turns governing the annual political qi. Each year has its own waxing and waning, completing a cycle in six years, totaling the waxing and waning patterns of the six-six cycles. There are fixed positions for upper and lower, and guidelines for left and right. This refers to the positions of yin and yang waxing and waning each year: "upper and lower" refer to the two positions of Si Tian (Sovereign Heaven) and Zai Quan (In Spring); "left and right" refer to the left and right interstitial spaces of Si Tian and the left and right interstitial spaces of Zai Quan, forming four guidelines. Whenever the yin and yang qi rotating to the right by Heaven approaches the position of Si Tian, the political qi of Heaven is vigorous and begins to disseminate from the third Qi; whenever it approaches the position of Zai Quan, the qi of Earth is vigorous and begins to disseminate from the final Qi. Thus, the upper and lower positions have two rhythms of waxing and waning yin and yang. Approaching the left interstitial space of Si Tian, its qi becomes vigorous at the fourth Qi; approaching the right interstitial space, its qi becomes vigorous at the second Qi. Approaching the left interstitial space of Zai Quan, its qi becomes vigorous at the first Qi; approaching the right interstitial space, its qi becomes vigorous at the fifth Qi. Thus, the four guidelines on the left and right have four rhythms of waxing and waning yin and yang. Therefore, these six rhythmic yins and yangs each have one waxing and waning per year, summing up to six. In Yin and Shen years, Shaoyang (Lesser Yang) fire qi rotates to govern Si Tian, treated as the initial six; to the right of Shaoyang, in Mao and You years, Yangming (Greater Yang) dryness qi rotates to govern Si Tian, treated as six-two; to the right of Yangming, in Chen and Xu years, Taiyang (Greater Yang) cold qi rotates to govern Si Tian, treated as six-three; to the right of Taiyang, in Si and Hai years, Jueyin (Terminal Yin) wind qi rotates to govern Si Tian, treated as six-four; to the right of Jueyin, in Zi and Wu years, Shaoyin (Lesser Yin) heat qi rotates to govern Si Tian, treated as six-five; to the right of Shaoyin, in Chou and Wei years, Taiyin (Greater Yin) dampness qi rotates to govern Si Tian, treated as six-six; to the right of Taiyin, it cycles back to start with Shaoyang governing, hence called the waxing and waning of the six-six cycles. All these Three Yin and Three Yang serving as governing qi are referred to as the Biao (Markers) of the Six Qi. Those facing south waiting indicate that mentioned previously regarding Shaoyang's right, etc., all stand facing south to wait, meaning residing on the right in the West and rotating past the East from the West. Above Shaoyang, Fire Qi governs, revealing Jueyin in the middle; above Yangming, Dryness Qi governs, revealing Taiyin in the middle; above Taiyang, Cold Qi governs, revealing Shaoyin in the middle; above Jueyin, Wind Qi governs, revealing Shaoyang in the middle; above Shaoyin, Heat Qi governs, revealing Taiyang in the middle; above Taiyin, Dampness Qi governs, revealing Yangming in the middle. These Fire, Dryness, Wind, Cold, Heat, and Dampness, as governing qi, are all referred to as the Ben (Roots) of the Six Qi. The revealed qi in the middle is the Zhong Qi (Middle Qi) of the Six Qi. Speaking generally of the Biao of the previous Six Qi, the Ben is above, the Biao is below, and the Zhong Qi resides between the Ben and the Biao. Thus, it is said: Below the Ben is the manifestation of the Middle; below the manifestation of the Middle is the Biao of the Qi. The Zhong Qi consists of the Three Yin and Three Yang, each cooperating and guarding like husband and wife, and the human Zang-Fu organs and meridians all correspond to them. Thus, the Zhong Qi revealed in the Ben and Biao of Shaoyang is Jueyin, and the Zhong Qi revealed in the Ben and Biao of Jueyin is Shaoyang; they guard each other as Zhong Qi, so the Gallbladder and Sanjiao (Triple Burner) meridians of Shaoyang also connect to the Liver and Pericardium, while the Liver and Pericardium meridians of Jueyin also connect to the Gallbladder and Sanjiao, intersecting mutually. The Zhong Qi revealed in the Ben and Biao of Yangming is Taiyin, and the Zhong Qi revealed in the Ben and Biao of Taiyin is Yangming; they guard each other as Zhong Qi, so the Stomach and Large Intestine meridians of Yangming also connect to the Spleen and Lung, while the Spleen and Lung meridians of Taiyin also connect to the Stomach and Large Intestine, intersecting mutually. The Zhong Qi revealed in the Ben and Biao of Taiyang is Shaoyin, and the Zhong Qi revealed in the Ben and Biao of Shaoyin is Taiyang; they guard each other as Zhong Qi, so the Bladder and Small Intestine meridians of Taiyang also connect to the Kidney and Heart, while the Kidney and Heart meridians of Shaoyin also connect to the Bladder and Small Intestine, intersecting mutually. When the Ben and Biao differ, and the corresponding phenomena of Qi vary, this refers to the Taiyang and Shaoyin qi. Above Taiyang, Cold Qi governs; this means the Biao is Yang and the Ben is Cold, differing. When the Qi corresponds, Taiyang's arrival brings Cold generation, while the middle brings Warmth, resulting in different phenomena of Cold and Warmth. Above Shaoyin, Heat Qi governs; this means the Biao is Yin and the Ben is Heat, differing. When the Qi corresponds, Shaoyin's arrival brings Heat generation, while the middle brings Cold, resulting in different phenomena of Heat and Cold. As for the pulse following the disease in reverse, such as melon rind being sweet and pulp bitter, scallion white part green and leaf blue, Ginseng tonifying and Rhizoma Ginseng (Lu) purging, Ephedra inducing sweating while roots and nodes stopping sweat—these are all examples of the different phenomena of Qi due to the differing Ben and Biao of Taiyang and Shaoyin. There are cases where the term arrives and the climate arrives (Zhi Er Zhi), where the term arrives but the climate does not (Zhi Er Bu Zhi), and where the term arrives but the climate is excessive (Zhi Er Tai Guo). This means when the timing of the Yin-Yang rotation governing the year arrives, and its Qi transformation also arrives according to the timing, it is called "Zhi Er Zhi" and is harmonious. If the timing arrives but the Qi transformation does not, it is called "Zhi Er Bu Zhi," indicating the incoming Qi is insufficient. If the timing has not arrived but the Qi transformation arrives first, it is called "Wei Zhi Er Zhi," indicating the incoming Qi is in excess. Therefore, when Qi transformation corresponds to the timing, arriving on time is Shun (smooth/obedient); arriving early or late is Ni (contrary/rebellious). Ni generates changes of victory and revenge; changes generate diseases. "All things grow responding to Qi, pulses respond to Qi" reiterates the meaning that correspondence implies Shun. The scripture says "What Jueyin brings is Wind generation," which is the response of thing growth; "When Jueyin arrives, its pulse is Wiry," which is the response of Qi and pulse.

[Diagram of Waxing and Waning of Six-Six Cycles of Heavenly Dao 1]
[Diagram of Waxing and Waning of Six-Six Cycles of Heavenly Dao 2]
Shaoyang governs the six-cycle waxing and waning of Yin and Shen years. Yangming governs the six-cycle waxing and waning of Mao and You years.
Taiyang governs the six-cycle waxing and waning of Chen and Xu years. Jueyin governs the six-cycle waxing and waning of Si and Hai years.
[Diagram of Waxing and Waning of Six-Six Cycles of Heavenly Dao 3]
[Diagram of Waxing and Waning of Six-Six Cycles of Heavenly Dao 4]
Shaoyin governs the six-cycle waxing and waning of Zi and Wu years. Taiyin governs the six-cycle waxing and waning of Chou and Wei years.
[Diagram of Waxing and Waning of Six-Six Cycles of Heavenly Dao 5]
[Diagram of Waxing and Waning of Six-Six Cycles of Heavenly Dao 6]
[Diagram of Ben, Biao, and Middle Qi of Each of the Six Qi]
Fire, Dryness, Wind, Cold, Heat, Dampness are the Ben; Three Yin and Three Yang are the Biao; the revealed in the middle of Ben and Biao is the Zhong Qi.
Above Shaoyang, Fire Qi governs, revealing Jueyin in the middle.
Above Jueyin, Wind Qi governs, revealing Shaoyang in the middle.
Above Yangming, Dryness Qi governs, revealing Taiyin in the middle.
Above Taiyin, Dampness Qi governs, revealing Yangming in the middle.
Above Taiyang, Cold Qi governs, revealing Shaoyin in the middle.
Above Shaoyin, Heat Qi governs, revealing Taiyang in the middle.
[Diagram of Human Zang-Fu Organs and Meridians Corresponding to Heavenly Six Qi with Ben and Biao]
The Five Zang and Six Fu organs are the Ben; the Twelve Meridians are the Biao; what connects between Ben and Biao is the Zhong Qi. The Ben of Zang-Fu resides internally, the Zhong Qi resides between interior and exterior, and the Biao of meridians is exterior.
Foot Shaoyang belongs to Gallbladder and connects to Liver.
Hand Shaoyang belongs to Sanjiao and connects to Pericardium.
Foot Jueyin belongs to Liver and connects to Gallbladder.
Hand Jueyin belongs to Pericardium and connects to Sanjiao.
Foot Yangming belongs to Stomach and connects to Spleen.
Hand Yangming belongs to Large Intestine and connects to Lung.
Foot Taiyin belongs to Spleen and connects to Stomach.
Hand Taiyin belongs to Lung and connects to Large Intestine.
Foot Taiyang belongs to Bladder and connects to Kidney.
Hand Taiyang belongs to Small Intestine and connects to Heart.
Foot Shaoyin belongs to Kidney and connects to Bladder.
Hand Shaoyin belongs to Heart and connects to Small Intestine.

The Yellow Emperor said: Good. I wish to hear how Geography responds to the positions of the Six Qi and Solar Terms. Qibo said: To the right of Xian Ming (Clear Manifestation), is the position of Jun Huo (Monarch Fire); to the right of Jun Huo, moving backward one step, Xiang Huo (Minister Fire) governs; moving forward one step again, Earth Qi governs; moving forward one step again, Metal Qi governs; moving forward one step again, Water Qi governs; moving forward one step again, Wood Qi governs; moving forward one step again, Jun Huo governs. Below Xiang Huo, Water Qi succeeds it; below the Water position, Earth Qi succeeds it; below the Earth position, Wind Qi succeeds it; below the Wind position, Metal Qi succeeds it; below the Metal position, Fire Qi succeeds it; below Jun Huo, Yin Jing (Yin Essence) succeeds it. The Yellow Emperor asked: Why? Qibo said: Excess causes harm; succession leads to control; control allows for generation and transformation; externally displaying waxing and waning. Harm leads to ruin and chaos; generation and transformation lead to major diseases. The Yellow Emperor asked: How are waxing and waning? Qibo said: Not in its position makes it Xie (Evil/Pathogenic); in its position makes it Zheng (Correct/Upright). Pathogenic changes are severe; upright changes are mild. The Yellow Emperor asked: What is meant by "in its position"? Qibo said: Wood Yun (Movement) meeting Mao year, Fire Yun meeting Wu year, Earth Yun meeting the four seasons months, Metal Yun meeting You year, Water Yun meeting Zi year—this is called Sui Hui (Year Assembly), the peace of Qi. The Yellow Emperor asked: What about not in position? Qibo said: The year does not assemble with Yun. The Yellow Emperor asked: In years of Earth Yun, seeing Taiyin above; in years of Fire Yun, seeing Shaoyang and Shaoyin above; in years of Metal Yun, seeing Yangming above; in years of Wood Yun, seeing Jueyin above; in years of Water Yun, seeing Taiyang above—what then? Qibo said: This is Heaven assembling with Yun. Thus, the *Tianyuan Ce* calls it Tian Fu (Heavenly符/Symbol). The Yellow Emperor asked: What about Tian Fu and Sui Hui? Qibo said: It is the assembly of Taiyi Tian Fu. The Yellow Emperor asked: How do their nobility and baseness compare? Qibo said: Tian Fu is the Law Enforcer, Sui Wei is the Order Executor, Taiyi Tian Fu is the Noble Person. The Yellow Emperor asked: How does pathogenic Qi strike humans? Qibo said: Striking the Law Enforcer, the disease is rapid and critical; striking the Order Executor, the disease is slow and persistent; striking the Noble Person, the disease is violent and fatal. The Yellow Emperor asked: How does the change of position work? Qibo said: Monarch position serving Minister is Shun (smooth); Minister position serving Monarch is Ni (contrary). Ni means the disease is near and harm is rapid; Shun means the disease is distant and harm is slight. This is referred to as the Two Fires. (From *Suwen: Liuhui Zhi Dalun*)

This chapter discusses the Yin and Yang of Earth, and the normal course of Earth's leftward rotation. By "lower," it refers to the leftward movement. Geography responding to the Six Qi and Solar Term positions divides the four directions of Earth into six steps, taking turns governing seasonal times to correspond to the governance of the external Heaven's Six Qi and Solar Term positions. "To the right of Xian Ming is the position of Jun Huo": Xian Ming refers to the rising sun at Mao (East). To the right of Mao, in the direction Southeast, in time Spring Equinox, after Mao hour, is the position of Jun Huo. "To the right of Jun Huo, moving backward one step, Xiang Huo governs": Earth Qi moves to the Southern position of Xiang Huo to issue orders, governing the Third Qi around the Summer Solstice, corresponding to the dissemination of Si Tian's politics. Its Yun governs Wu and Gui years, corresponding to Si Tian's politics governing the year. "Moving forward one step again, Earth Qi governs": Earth Qi moves to the Southwest Earth position to issue orders, governing the Fourth Qi before the Autumn Equinox, corresponding to the prosperity of Si Tian's left interstitial Qi. Its Yun governs Jia and Ji years, corresponding to Si Tian's politics governing the year. "Moving forward one step again, Metal Qi governs": Earth Qi moves to the Northwest Metal position to issue orders, governing the Fifth Qi after the Autumn Equinox, corresponding to the Qi of Zai Quan's right interstitial space. Its Yun governs Yi and Geng years, corresponding to Si Tian's politics governing the year. "Moving forward one step again, Water Qi governs": Earth Qi moves to the Northern Water position to issue orders, governing the Final Qi around the Winter Solstice, corresponding to the dissemination of Zai Quan's Qi. Its Yun governs Bing and Xin years, corresponding to Si Tian's politics governing the year. "Moving forward one step again, Wood Qi governs": Earth Qi moves to the Northeast Wood position to issue orders, governing the First Qi before the Spring Equinox, corresponding to the prosperity of Zai Quan's left interstitial Qi. Its Yun governs Ding and Ren years, corresponding to Si Tian's politics governing the year. "Moving forward one step again, Jun Huo governs": Earth Qi moves to the Southeast Jun Huo position to issue orders, governing the Second Qi after the Spring Equinox, corresponding to the prosperity of Si Tian's right interstitial Qi. Its Yun covers the whole year, governed by Xiang Huo instead, not governing the year itself. During these six steps of governance, each brings the Qi of its native direction into China. Thus, when Wood Qi governs in the East, Spring Qi moves West, and China is influenced by Eastern Warm Qi and the Qi residing in Zai Quan's left interstitial space. When Jun and Xiang Huo govern in the South, Summer Qi moves North, and China is influenced by Southern Hot Qi and the Qi residing in Si Tian's right interstitial space. When Metal Qi governs in the West, Autumn Qi moves East, and China is influenced by Western Cool Qi and the Qi residing in Si Tian's left interstitial space. When Water Qi governs in the North, Winter Qi moves South, and China is influenced by Northern Cold Qi and the Qi residing in Zai Quan's right interstitial space. Below each of the Six Qi, there is Qi succeeding and controlling it. This is because the Qi of the Five Elements, upon reaching extremity, generates anew, cycling continuously without a moment's break. Below Xiang Huo, Water Qi succeeds it: Summer Xiang Huo reaches extremity, Water generates to succeed it, transforming from slight to prominent until Winter. Below the Water position, Earth Qi succeeds it: Winter Water reaches extremity, Earth generates to succeed it, transforming from slight to prominent until Late Summer. Below the Earth position, Wood Qi succeeds it: Late Summer Earth reaches extremity, Wood generates to succeed it, transforming from slight to prominent until Spring. Below the Wood position, Metal Qi succeeds it: Spring Wood reaches extremity, Metal generates to succeed it, transforming from slight to prominent until Autumn. Below the Metal position, Fire Qi succeeds it: Autumn Metal reaches extremity, Fire generates to succeed it, transforming from slight to prominent until Summer. Below Jun Huo, Yin Jing succeeds it: Summer Jun Huo reaches extremity, Yin Jing succeeds it, transforming from slight to prominent until Winter. This meaning is largely similar to the Yin-Yang school's theory of Water gestating at Wu and Metal gestating at Mao, all cycling to form gestation. "Kang" (Excess) means extreme. Kang Ze Hai, Cheng Nai Zhi, Zhi Ze Sheng Hua, Wai Lie Sheng Shuai, Hai Ze Bai Luan, Sheng Hua Da Bing: This means if the Qi of the six positions reaches extremity, harm arises; the succeeding Qi generates below to control it, preventing excess. Thus, control allows transformation from slight to prominent; the successor displays prosperity externally, the extreme displays decline externally, and generation/transformation cycles. Harm leads to ruin and chaos, causing major diseases in generation/transformation. "Sheng Shuai Fei Qi Wei Ze Xie, Dang Qi Wei Ze Zheng" reiterates the waxing and waning of "Control allows generation/transformation, externally displaying waxing and waning." Generally, the waxing and waning of controlling excess and succeeding generation/transformation: only when Year Qi is peaceful does its transformation proceed step-by-step from slight to prominent, fitting the correct positions of the six positions. If Year Qi has excess or insufficiency, its transformation is disordered, leaping stages or attacking dangers, so changes may be mixed transformations, becoming half-pathogenic due to non-position; or changes may be revenge victories, becoming fully pathogenic due to non-position. "Wood Yun meeting Mao, Fire Yun meeting Wu, Earth Yun meeting four seasons, Metal Yun meeting You, Water Yun meeting Zi" is called Sui Hui, peace of Qi. This means in these eight years, Year Qi meets Five Yun movements, resulting in peaceful Qi, where waxing and waning follow order and fit the correct positions of the six positions. For other years not meeting Yun, Qi has excess or insufficiency, and waxing and waning are disordered and non-positional. Some say: Wang's commentary explains "Water succeeding below Fire" as heat being so great it overflows like water; "Earth succeeding below Water" as cold being so great ice hardens like earth; "Wind succeeding below Earth" as rain blown by fierce winds scatters; "Metal succeeding below Wind" as wind moving clears Qi, making all things dry; "Fire succeeding below Metal" as fire smelts metal. Lin's correction cites "Wood erupts and breaks" and "Jueyin's arrival brings floating anger and great coolness" as evidence. He Jian further wrote books expanding on these two schools' theories using the meaning of "Kang Ze Hai, Cheng Nai Zhi." Their views all point to the Qi succeeding below the six positions as sudden daily occurrences. Now you alone claim it is a four-season cycle; you must have an explanation to clarify it and prove its gains, losses, right, and wrong. I reply: The scripture's subsequent sentences "Control allows generation/transformation, externally displaying waxing and waning; waxing and waning in position is Zheng, not in position is Xie" discuss the meaning of succeeding Qi intimately and comprehensively, sufficient to prove its gains, losses, right, and wrong. Now the scripture says: "To the right of Jun Huo, moving backward one step, Xiang Huo governs, Water Qi succeeds it; moving forward one step, Earth Qi governs, Wood Qi succeeds it; moving forward one step, Metal Qi governs, Fire Qi succeeds it; moving forward one step, Water Qi governs, Earth Qi succeeds it; moving forward one step, Wood Qi governs, Metal Qi succeeds it; moving forward one step, Jun Huo governs, Yin Jing succeeds it." This section describes the waxing and waning of succeeding generation/transformation, which is Zheng when in position. Generally, its waxing and waning proceed in order without disorder. The prosperous ones occupy the correct positions of law; the declining ones occupy the correct positions of succession, each fitting the correct position of its own nature. Thus, Warm fits Spring, Hot fits Summer, Cool fits Autumn, Cold fits Winter, resulting in peaceful climate for Growth, Harvest, Storage, and Emission. This is the fundamental intent of the scripture, discussing the four-season cycle and correct transformation in position. Wang's commentary's explanation of succeeding Qi, citing Lin's "Wood erupts and breaks" and "Jueyin's arrival brings floating anger and great coolness," refers to the waxing and waning of succeeding generation/transformation, which is Xie when not in position. Generally, its waxing and waning are disordered and chaotic. Thus, "Wood erupts and breaks" refers to violently excessive Wood floating, partially combining with the violent succeeding Metal's killing energy to transform together, resulting in half-waxing/half-declining not in position, becoming a mixed-transformation pathogen. "Jueyin's arrival brings floating anger and great coolness" refers to violently excessive Wood floating and raging, retaliated against by the violent succeeding Metal's coolness, resulting in full-waxing/full-declining not in position, becoming a victory-revenge pathogen. Thus, Warm is not Spring, Hot is not Summer, Cool is not Autumn, Cold is not Winter, alternating between harmony and discord, causing various human diseases. This is Wang and Lin mistakenly using sudden daily non-positional pathogens to explain the scripture's positional correctness. However, these non-positional mixed transformations and victory-revenges differ in excess and insufficiency. Now He Jian expands Wang and Lin's theories, using "Kang Ze Hai, Cheng Nai Zhi" to explain changing Qi. He says: Wood extreme resembles Metal, Metal extreme resembles Fire, Fire extreme resembles Water, Water extreme resembles Earth, Earth extreme resembles Wood—all because excess beyond extremity reverses to resemble the transformation of the element overcoming it. He says: Control being too strong leads to mixed transformation, which is a false appearance. He says: Treating mixed transformation should only purge the excessively excessive Qi as the root of disease, not mistakenly treat the mixed transformation. These scholars' words all refer to the mixed transformation of the five Qi's changing prosperity. As for insufficiency, they have not addressed it. Carefully consulting *Wuchang Zheng Dalun*: Wood insufficiency is called Wei He. In the record of Wei He, its movement is stiffness, constraint, and laxity; its taste is sour and pungent; its color is white and pale; its sound is Jue and Shang. Fire insufficiency is called Fu Ming. In the record of Fu Ming, its movement is manifest hiddenness and change; its taste is bitter and salty; its color is dark and red; its sound is Zhi and Yu. Earth insufficiency is called Bei Jian. In the record of Bei Jian, its movement is ulcers, swelling, splitting, ulceration, and carbuncles; its taste is sour and sweet; its color is pale and yellow; its sound is Gong and Jue. Metal insufficiency is called Cong Ge. In the record of Cong Ge, its movement is clanging, restriction, dizziness, and reversal; its taste is bitter and pungent; its color is white and red; its sound is Shang and Zhi. Water insufficiency is called He Liu. In the record of He Liu, its movement is hardness and stillness; its taste is sweet and salty; its color is dark; its sound is Yu and Gong. "Wei He" refers to softness, stiffness, constraint, and laxity: Wang's note defines "shortening." Basically, Wood's spreading nature is insufficient and reaches extremity, so Metal mixed-transforms shortening, succeeding in non-position to overcome it. "Li" means limb curvature. "Ju" means tendon and vessel constraint. Wood is pulled by Metal's shortening, causing curvature and constraint. "Huan" means tendon and vessel laxity. Metal overcoming Wood makes Earth lack fear, so Earth mixed-transforms laxity in its gaps, so constrained remains constrained, lax remains lax. Sour, Pungent, White, Pale, Jue, Shang are all Wood insufficiency reaching extremity, with Metal succeeding in non-position to mixed-transform. "Fu Ming" refers to manifest hiddenness and change: "Zhang" means Fire transformation is manifest. "Fu" means Water transformation is hidden. "Bian Yi" means Fire insufficiency allows Water to mix in, sometimes manifest, sometimes hidden, changing irregularly. Bitter, Salty, Dark, Red, Zhi, Yu are all Fire insufficiency reaching extremity, with Water succeeding in non-position to mixed-transform.